PT - JOURNAL ARTICLE AU - Timothy J R Panneflek AU - Kristel L A M Kuypers AU - Graeme R Polglase AU - Stuart B Hooper AU - Thomas van den Akker AU - Arjan B te Pas TI - Effect of clinical chorioamnionitis on breathing effort in premature infants at birth: a retrospective case–control study AID - 10.1136/archdischild-2022-324695 DP - 2022 Nov 23 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - fetalneonatal-2022-324695 4099 - http://fn.bmj.com/content/early/2022/11/23/archdischild-2022-324695.short 4100 - http://fn.bmj.com/content/early/2022/11/23/archdischild-2022-324695.full AB - Rationale Antenatal inflammation, usually associated with chorioamnionitis, is a major cause of premature birth. As inflammation could depress respiratory drive, we have examined the effect of clinical chorioamnionitis (CCA) on spontaneous breathing in premature infants at birth.Methods Infants with CCA born <30 weeks’ gestation were matched with control infants based on gestational age (±6 days), birth weight (±300 g), antenatal corticosteroids, sex and general anaesthesia. The primary outcome was breathing effort, assessed as minute volume (MV) of spontaneous breathing. We also measured tidal volume (Vt), respiratory rate (RR) and apnoea in the first 5 min and additional physiological parameters in the first 10 min after start of respiratory support.Results Ninety-two infants were included (n=46 CCA infants vs n=46 controls; median (IQR) gestational age 26+4 (25+0–27+6) vs 26+6 (25+1–28+3) weeks). MV and Vt were significantly lower (MV: 43 (17–93) vs 70 (31–119) mL/kg/min, p=0.043; Vt: 2.6 (1.9–3.6) vs 2.9 (2.2–4.8) mL/kg/breath, p=0.046), whereas RR was similar in CCA infants compared with controls. Incidence of apnoea was higher (5 (2-6) vs 2 (1-4), p=0.002), and total duration of apnoea was longer (90 (21-139) vs 35 (12-98) s, p=0.025) in CCA infants. CCA infants took significantly longer to reach an oxygen saturation >80% (3:37 (2:10–4:29) vs 2:25 (1:06–3:52) min, p=0.016) and had a lower oxygen saturation at 5 min (77 (66–92) vs 91 (68–94) %, p=0.028), despite receiving more oxygen (62 (48-76) vs 54 (43-73) %, p=0.036).Conclusion CCA is associated with reduced breathing effort and oxygenation in premature infants at birth.All data relevant to the study are included in the article or uploaded as supplementary information.